AccountId: 011433970860
ContactId: 64dae708-b201-474d-9f13-f25dc85d1bc6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 324079 ms
Total Talk Time (AGENT): 105275 ms
Total Talk Time (CUSTOMER): 70042 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/64dae708-b201-474d-9f13-f25dc85d1bc6_20250613T21:14_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII]. I'm calling with South Miami Hospital to verify benefits for a patient.
[AGENT][POSITIVE] Sure, I can help you with benefits. Um, can you spell your name for me, please?
[CUSTOMER][NEUTRAL] Yes, that would be [PII] The initial of my last name is [PII]
[AGENT][NEUTRAL] And uh what provider are you calling from again?
[CUSTOMER][NEUTRAL] South Miami Hospital.
[AGENT][NEUTRAL] And what's a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] The policy number I have is 1071616.
[AGENT][NEUTRAL] Alright, let me look that up.
[AGENT][NEUTRAL] Can you verify the patient's name and date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII]. Uh, date of birth is [PII].
[AGENT][POSITIVE] Thank you so much for verifying that with me.
[AGENT][NEUTRAL] And I'm pulling up his policy now. Um, were there specific benefits that you needed, inpatient or outpatient?
[CUSTOMER][NEUTRAL] Outpatient. You're gonna be seen for an ultrasound.
[AGENT][NEUTRAL] OK, give me just a moment.
[AGENT][NEUTRAL] And I do want to say that this is just a verification of benefits, not a guarantee of payment.
[AGENT][NEUTRAL] It looks like he has an outpatient.
[AGENT][NEUTRAL] Benefit maximum of up to $500 per occurrence with a $0 deductible.
[AGENT][NEUTRAL] It looks like uh he is covered for hospital emergency room or urgent urgent care, outpatient surgery, uh, diagnostic testing, and outpatient treatment for mental or emotional disorders. And you said it was for an ultrasound, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me check and see.
[CUSTOMER][NEUTRAL] And I'm so sorry. What would be the effective date of the policy?
[AGENT][NEUTRAL] Uh, it's [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] I'm not seeing if ultrasounds are covered by this policy. Uh, let me look.
[AGENT][NEUTRAL] It looks like MRIs are covered, but I'm not seeing ultrasound specifically.
[CUSTOMER][POSITIVE] Alrighty um.
[CUSTOMER][NEUTRAL] Uh, would it be under maybe diagnostic X-rays?
[AGENT][NEUTRAL] Um, I am showing that diagnostic testing in a hospital outpatient facility is covered, um, but it didn't have any, um, exclusion as to what type of testing. It just has diagnostic testing and MRI.
[CUSTOMER][POSITIVE] Alrighty
[CUSTOMER][NEUTRAL] OK. Um, and he's only covered up to $500?
[AGENT][NEUTRAL] Uh, per occurrence, yes.
[CUSTOMER][NEUTRAL] For occurrence. OK. And has he, I mean, has he used anything so far or?
[AGENT][NEUTRAL] Let me check.
[AGENT][NEUTRAL] No ma'am, he is not.
[CUSTOMER][NEUTRAL] Alrighty, well, I mean, I guess that's really all I needed for today. Would I be able to get a reference number for the call?
[AGENT][NEUTRAL] So we don't have call reference numbers you can use my name and last initial in today's date, so [PII] in today's date.
[CUSTOMER][POSITIVE] Perfect thank you so much hope you have a great day.
[AGENT][POSITIVE] Thank you for calling APL. Have a great weekend.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.